School of Food and Biological Engineering, Shaanxi University of Science and Technology, Xi an, China.
Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China.
Crit Rev Food Sci Nutr. 2021;61(10):1670-1688. doi: 10.1080/10408398.2020.1764488. Epub 2020 May 21.
Although many studies have shown that consumption of probiotics is relevant to diabetes, the effects of probiotics improves clinical outcomes in type 2 diabetes have yielded conflicting results. The aim of this meta-analysis was conducted to assess the effects of probiotics supplementation on glycemic, blood lipids, pressure and inflammatory control in type 2 diabetes. PubMed, Web of science, Embase and the Cochrane Library databases were searched for relevant studies from February 2015 up to Janurary 2020, with no language restrictions. The pooled results were calculated with the use of a random-effects model to assess the impact of supplemental probiotics on glycemic, blood lipids, pressure and inflammatory control in type 2 diabetes. Additionally, subgroup analysis was conducted based on patients age, body mass index (BMI), country and duration of the probiotics supplement, respectively. 13 studies were included in this meta-analysis, involving a total of 818 participants in 8 countries. Overall, compared with control groups, the subjects who received multiple species of probiotics had a statistically significant reduction in fasting blood sugar (FBS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglycerides (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP) and tumor necrosis factor (TNF) -α [standardized mean difference (SMD): -0.89 mg/Dl, 95% CI: -1.66, -0.12 mg/dL; SMD: -0.43, 95% CI: -0.63, -0.23; SMD: -0.19 mg/dL, 95% CI: -0.36, -0.01 mg/dL; SMD: -0.23 mg/dL, 95% CI: -0.40, -0.05 mg/dL; SMD: -5.61 mmHg, 95% CI: -9.78, -1.45 mmHg; SMD: -3.41 mmHg, 95% CI: -6.12, -0.69 mmHg; and SMD: 6.92 pg/ml, 95% CI: 5.95, 7.89 pg/ml, respectively]. However, the subjects who received single-species of probiotic or probiotic with co-supplements in food only changed FBS, HOMA-IR, DBP and TG levels. Moreover, subgroup analyses revealed that the effects of probiotics supplementation on FBS, HMOA-IR, SBP and DBP are significantly influenced by patients age, body mass index (BMI), country and duration of the probiotics supplement. Our analysis revealed that glycemic, lipids, blood pressure and inflammation indicators are significantly improved by probiotic supplementation, particularly the subjects who ages ≤ 55, baseline BMI< 30 kg/m, duration of intervention more than 8 weeks, and received multiple species probiotic.
虽然许多研究表明益生菌的摄入与糖尿病有关，但益生菌对 2 型糖尿病临床结局的影响却产生了相互矛盾的结果。本荟萃分析旨在评估益生菌补充剂对 2 型糖尿病患者血糖、血脂、血压和炎症控制的影响。从 2015 年 2 月至 2020 年 1 月，我们在 PubMed、Web of Science、Embase 和 Cochrane Library 数据库中检索了相关研究，没有语言限制。使用随机效应模型计算汇总结果，以评估补充益生菌对 2 型糖尿病患者血糖、血脂、血压和炎症控制的影响。此外，还分别根据患者年龄、体重指数（BMI）、国家和益生菌补充剂的持续时间进行了亚组分析。这项荟萃分析共纳入了 13 项研究，涉及来自 8 个国家的 818 名参与者。总体而言，与对照组相比，接受多种益生菌的受试者空腹血糖（FBS）、稳态模型评估的胰岛素抵抗（HOMA-IR）、总胆固醇（TC）、甘油三酯（TG）、收缩压（SBP）、舒张压（DBP）和肿瘤坏死因子（TNF）-α显著降低[标准化均数差（SMD）：-0.89mg/dL，95%置信区间：-1.66，-0.12mg/dL；SMD：-0.43，95%置信区间：-0.63，-0.23；SMD：-0.19mg/dL，95%置信区间：-0.36，-0.01mg/dL；SMD：-0.23mg/dL，95%置信区间：-0.40，-0.05mg/dL；SMD：-5.61mmHg，95%置信区间：-9.78，-1.45mmHg；SMD：-3.41mmHg，95%置信区间：-6.12，-0.69mmHg；SMD：6.92pg/ml，95%置信区间：5.95，7.89pg/ml]。然而，仅接受单一品种益生菌或益生菌与食物补充剂的受试者，其 FBS、HOMA-IR、DBP 和 TG 水平发生变化。此外，亚组分析表明，益生菌补充剂对 FBS、HMOA-IR、SBP 和 DBP 的影响显著受患者年龄、体重指数（BMI）、国家和益生菌补充剂持续时间的影响。我们的分析表明，血糖、血脂、血压和炎症指标均显著改善，尤其是年龄≤55 岁、基线 BMI<30kg/m、干预时间超过 8 周、接受多种益生菌的患者。
